Is introducing solids before six months okay?

Your mum keeps telling you to wait until your baby is 6 months old to whip out the zucchini puree but your best friend keeps saying you need to start solids now, even though your baby is only 4 months old. They’ve both gave great reasons why you should start solids, so how do you work out what to do?

Baby feeding guidelines

Baby feeding guidelines are a good place to start. Although they probably won’t be as absorbing as the great novel that has been waiting patiently on your bedside table, they’ll provide information about breastfeeding and complementary foods that you know is reliable and based on current scientific knowledge. And to save you a bit of reading, we’ve put together the key points about when to (and when not to) start solids.

Australian and international guidelines recommend exclusive breastfeeding (or formula feeding when breastfeeding is not possible) for the first six months (180 days) of your baby’s life. There are a few exceptional cases (see below), but unless you’ve been advised otherwise by your doctor, it’s safe to assume that 6 months or 180 days after birth is the right time to introduce your baby to solid foods.

However, guidelines from some other countries (e.g. the United States) recommend introducing solid foods at any time from 4-6 months. It’s little wonder that new mums are sometimes confused about what they should do when it comes to exclusive breastfeeding and introducing solids!

Why is exclusive breast feeding until 6 months so important?

Breast and formula milk both play an important role in meeting a growing baby’s nutritional needs in the first year of life and particularly in the first six months. The process of bottle or breastfeeding also plays an important role in your baby’s emotional and physical development.

A group of experts from the World Health Organisation found that there are no health benefits for babies who start eating solids early. On the contrary, these experts found evidence that early introduction of solids may have negative nutritional, physical and emotional effects on babies. Introducing solids earlier than six months of age can be detrimental because baby is not nutritionally, emotionally or physically ready to take on challenges like sitting up, chewing and swallowing.

More information on the disadvantages of introducing solids early.

Myths about early introduction of solids

Despite strong evidence showing that exclusive breast or formula feeding is best for babies until six months of age, myths about the benefits of introducing solid food early persist. Some parents start feeding their babies solids before six months of age. Some may judge that their baby seems ready to start solids. Others might believe that their baby will gain more weight if they begin eating solids at an earlier age or that solid foods will help them sleep through the night. There is no evidence to support these claims. Indeed there is no evidence of any benefit at all of introducing solids before six months of age.

In the past it was also believed that the early introduction of solid foods protected a baby from developing food allergies. However, experts now believe the opposite is true. Breastmilk protects against allergy and babies that breastfeed exclusively until 6 months are less likely to be allergic to food and other substances.

Exceptional cases

Exclusive breastfeeding (or if unable to breastfeed, exclusive formula bottles) is recommended for the first six months of a baby’s life. Only in exceptional circumstances may baby require other nutritional sources.

Undernourished mother

In most cases a mother who has nutritional problems can and should continue breastfeeding. Even a mother with moderate malnutrition can produce good quality breastmilk, but they need to try and increase their food intake so that they can improve their own nutrition. Women who have a particular nutrient deficiency (e.g. iron-deficiency anaemia) will need to take vitamin supplements to ensure their breastmilk quality is good, but it’s still recommended that they keep breastfeeding. Only in cases where the mother is severely malnourished are alternatives to breastfeeding such as formula feeding in addition to breastfeeding, but not early introduction of solids recommended. Talk to your doctor if you have nutritional problems and don’t think you should be breastfeeding.

Iron deficient babies

Babies which are born iron deficient may require supplementary iron to complement breast milk before they reach six months of age. Because breastmilk contains relatively low levels of iron, most babies have a reserve of iron in their liver which keeps them going until 6 months of age when solid foods are introduced. However, babies born to anaemic (iron deficient) mothers or at a low birth weight may be iron-deficient. Breastmilk alone will not provide the nutrients these babies need. In these cases iron supplements are likely to be more effective than iron-containing solid foods. Speak with your doctor if you are concerned.

Premature babies

Premature babies also have lower stores of iron than those born at full-term, so it might be necessary to start them on solids a little earlier (as breastmilk is relatively low in iron. As a general rule, use the midpoint between your expected due date and the actual date you gave birth prematurely, as the date from which to start counting your baby’s age. Add 16 weeks to the midpoint and use this as the earliest possible date to introduce solids but don’t start any later than 7 months after the actual birth date. And always get advice from your doctor.

Fast development

If you believe your baby is ready to start complementary foods before they reach six months, talk to your doctor first. If your baby is at least four months of age and has doubled in weight since birth to weigh approximately 6 kilograms, and has good neck control and jaw movement, it may be appropriate to introduce solid foods slightly earlier. Babies who are consuming more than 900 grams (32 ounces) of infant formula milk, feeding more than every three hours and constantly showing signs of hunger, may require solid foods before six months of age. But make sure you speak to your doctor first if you think there’s a reason to start solids early.

Find out more about starting your baby on solids

References

1. World Health Organisation. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. 2009. (cited 13 September 2013). Available from: (URL link)
2. World Health Organisation. Guiding principles for feeding of the breastfed child. 2003. (cited 20 September 2013). Available from: (URL link)
3. Auckland District Health Board. First foods for premature babies. 2004. (cited 20 September 2013). Available from: (URL link)
4. Queensland Health. Introduction to Solids. 2008. (cited 20 September 2013). Available from: (URL link)
5. Anderson J. Confused about introducing solids? Australian Breastfeeding Association. 2012. (20 September 2013). Available from: (URL link)
6. Mayo Clinic Guide to Your Baby’s First Year. Mayo Foundation for Medical Education and Research. Good Books. Editors EH Kych, RV Johnson, WJ Cook. 2012. (Book)
7. Department of Health and Ageing. Get up and grow: 2009. (cited 20 September 2013) Available from: (URL link)